MR. Larry James Tedder, CDP
NPI #1376823526 in Kelso, Washington
Provider Information
- NPI Number
- 1376823526
- Entity Type
- Individual
- Name
- MR. Larry James Tedder, CDP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- CDP
- Enumeration Date
- Aug 19, 2011
- Last Updated
- Nov 21, 2019
Practice Location
- Address
- 305 PACIFIC AVE S STE 102
- City
- Kelso
- State
- Washington
- ZIP Code
- 98626-1638
- Phone
- (360) 577-7442
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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